A&E crisis: Nearly 1,000 deaths in Wales linked to 12-hour waits as calls grow for urgent action

New figures from the Royal College of Emergency Medicine reveal 965 deaths in 2025 were associated with long emergency department waits — an average of 18 people every week.

The total is up on the previous year, with doctors warning the scale of the crisis should send “shockwaves” through the political system.

“A matter of life and death”

Emergency medicine experts say the situation inside A&E departments has become critical.

Dr Rob Perry said many of those affected were among the most vulnerable patients — people already in need of urgent hospital care.

“Any number of avoidable deaths is a tragedy — that there were almost a thousand last year should send shockwaves,” he said.

“This is a matter of life and death.”

The report points to overcrowded hospitals, high bed occupancy and delays discharging patients as key drivers — leaving emergency departments gridlocked.t door” of emergency departments, but at the “back door” — where patients cannot be moved into wards quickly enough.

How delays are linked to deaths

The analysis suggests one death occurs for every 72 patients forced to wait 12 hours or more before being admitted.

Experts say tackling patient flow through hospitals — not just demand at the front door — is key to preventing further loss of life.

The College is now calling on all parties to commit to ending deaths associated with long waits by 2030.

Government: “Real progress” on waiting lists

The stark findings come just days after the Welsh Government published its latest NHS performance figures — highlighting improvements elsewhere in the system.

According to ministers:

  • The average waiting time for treatment has fallen to around 18 weeks
  • Waiting lists have dropped for eight months in a row
  • January saw a record monthly fall of 27,900 patients

Health Secretary Jeremy Miles said the figures showed “real, tangible progress”.

“Health boards are delivering more appointments and more operations… making sure people are seen and treated faster,” he said.

How delays are costing lives

The analysis uses a recognised measure suggesting one death occurs for every 72 patients forced to wait 12 hours or more.

That equates to hundreds of potentially avoidable deaths each year.

The College is now calling on all political parties to commit to ending deaths linked to long A&E waits by 2030, warning that failure to act will lead to more lives lost.

More operations — but pressure remains

The Welsh Government says the improvements have been driven by:

  • 187,000 extra outpatient appointments
  • A record 37,000 cataract operations
  • Additional £120 million funding

There have also been improvements in ambulance response times and hospital handovers.

But ministers acknowledge winter pressures remain high, with A&E departments recording one of their busiest periods on record.

Political pressure ramps up

The figures have prompted renewed criticism from the Welsh Conservatives.

Shadow Health Secretary Peter Fox said urgent action is needed.

“Every patient deserves timely care and no one should have to wait 12 hours or more,” he said.

“This data underlines the urgent need for strong, effective action.”

He reiterated calls to declare a health emergency to bring down waiting times and end corridor care.

Welsh Liberal Democrat Leader Jane Dodds MS put the blame firmly at an overstretched social care system.

“These figures are a national scandal. Nearly a thousand people dying after waiting over 12 hours in A&E reflects a system that is fundamentally broken and causing avoidable deaths. 

“For too long, the focus has been on the front door of hospitals, when the real crisis is at the back door. Patients cannot be discharged because social care is overstretched, beds remain blocked, and A&E departments become dangerously overcrowded.

“If we are serious about ending these avoidable deaths, the next Welsh Government must properly fund social care and take a whole-system approach to fixing patient flow and funding social care properly will be a red line in any negotiations we hold with other parties.”

Two pictures of the NHS

Together, the figures paint a complex picture of the Welsh NHS.

On one hand, waiting lists are falling and more patients are being treated.

On the other, emergency departments remain under severe pressure, with long waits continuing to be linked to hundreds of deaths each year.

With a Senedd election approaching, the challenge for politicians is clear — turning progress on paper into safer care on the frontline.

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High-flow nasal cannula prevents intubation, occasionally (Review)

But any patient could be lucky number 17, you know?

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Apparently bispecific T-cell engagers can cause time sensitive life threatening side effects that emergency clinicians must know about.

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Someone Please Help The Emergency Physician

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My New Year’s Eve – 2025

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31st December 2025. I was NOT oncall.

It was a Wednesday and it was a normal working day. Hence, at 7:45am, I left to work as usual and was there by 8am. It was the New Year’s Eve. I thought that maybe, just maybe, there would be less patients in the clinic.

The day started off smoothly. Surprisingly, there were many patients who came for their follow up followed by additional patients (the defaulters and walk-ins) but it was manageable. We went about our day, seeing each patient and when lunch time came, we went for our lunch break.

At 2pm, we went about our work, seeing patients as usual and I was taking my time with each patient. The patient load in the afternoon shift was lower compared to the morning shift and both my colleagues were done with their patient load.

Suddenly, a staff nurse barged into my room saying that there is a massive accident that just occurred nearby, 2 patients were already brought in and 2 more were on their way. They called in all available doctors (which were only the three of us) to help out.

I told my colleagues to head out and help out first while I rushed through the consultation of my final patient. After that, I rushed to the tiny Emergency Room of the clinic. My colleague who was oncall on that day was already attending to a child. I went over to the other patient, an old lady and did my primary survey and fast scan.

She was desaturating badly under room air and needed oxygen support. She had an open skull fracture, multiple abrasion and laceration wounds over her face, upper and lower limbs as well as rib fractures and on top of that, her left leg appears shortened and she has a closed fracture over her right lower limb.

I didn’t think that we should proceed with an x-ray at our clinic even if we had the facility at that time, the best would be to send them straight away to the hospital because she could deteriorate further any time. Thankfully, her GCS (Glasgow Coma Scale) was full.

I was focused on my patient, stabilising while referring her to the specialists of various specialities as well as the emergency physician that when I finally got ready to transfer her out that I noticed the child that my other colleague was attending to. The child’s right arm was crushed and the distal limb of his right arm was pale and his right lung was obvious till mid-chest.

Just how in the world is he still awake? The poor child was crying out in pain…

Judging by the state of his and my patient’s injuries, it was definitely high impact.

The story was, the whole family were travelling back from Miri to Kuching. Both the parents were sitting in front and the father was driving whilst the two children and their grandmother were sitting at the back.

The father claimed that he was not speeding but as he was about to make a u-turn at a junction, he claimed to have hit the curb and the car turned many times into the other lane before finally stopping and the grandmother and one of the child were thrown out of the car.

It sounded like a very high impact collision. Thankfully, the parents and the other child were well and unscathed.

We had to transfer both patients in two separate ambulances to the Red Zone of the Emergency Department at Hospital Bintulu as one ambulance could only transport one patient at a time.

Upon arriving, I met my colleague and friend at the Red Zone of the hospital. After we have handed over to the medical officers and specialist in the Emergency Department, we headed back together. However, upon reaching back, there was another patient who came in who was extremely tachypnoiec.

Oh, here we go again… Another Red Zone referral…

We stabilised the patient and referred her to hospital again. The clock was already showing 10pm when we left. The journey to the hospital takes about 45 minutes to an hour for each journey and the both of us have yet to have our dinner. This time, I choose to accompany her for the referral, mainly for emotional support and also in hopes of stopping by McDonald’s to get a takeout.

Yes, we did stop by McDonalds after sending the patient safely to the hospital and yes, we used the ambulance and went through drive-through.

By the time we left, it was already 11pm. The journey takes around 45 minutes to an hour and it was raining heavily. At this point, I was wondering if we would end up celebrating New Year’s in the ambulance.

Me and my friend ate in the ambulance on the way back while we joked and exchange oncall stories. Thankfully, we reached a little before midnight. The day was completely unexpected, not to mention tiring but it was nice to have spent it with a friend.

It’s still the beginning of 2026, so if I’m not too late, Happy New Year!

If you are travelling anytime soon or in the future, do drive safely, stay within speed limits especially if it is raining. Remember to get your car and tyres checked before any long distance journey and NEVER drive under the influence.

Stay safe always!

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12 Hours Shift – Counting Down My Hours Each Time At Work

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How do you waste the most time every day?

At the time of writing this article, which was back in June 2025, I was going through my 6th Rotation of my Housemanship which is in the Department of Emergency and Trauma. As a House Officer in the Emergency Department, we go by the 12-hours shift.

This meant, our shift is from:

  • AM Shift: 7am till 7pm
  • PM Shift: 10am till 10pm
  • Night Shift: 10pm till 10am

In this department, they are strict in regards to adhering to a minimum of 60 hours per week in total. Thus, in a week, our schedule is as follows;

  • A total of at least 4 daytime shifts (AM or PM Shifts)
  • One night shift
  • One off day

That is provided one has off-tagged of course.

Perhaps, it is the “last paper syndrome” that I was experiencing being in the 6th and final rotation, I would be counting down my hours each day at work. Thus, upon arrival at work, I would start my “12-hours countdown on my phone.

On slow days, I made it a point to go to toilet every hour, technically my so-called “hourly break” whereas on busy days, the toilet break is the only time I could take a break. This is followed by ensuring I have at least one meal per day during my shift.

Otherwise, the schedule in the emergency department is relatively better as compared to my previous rotations. Nevertheless, the tiredness is still there.

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A short article during my 6th and final rotation of my Housemanship period where we were required to complete a 12-hour shift every day.

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#medical #emergencydepartment #healthcare #housemanship #doctor #malaysia #blogging

http://theoreticaldoctor.com/2026/01/14/12-hours-shift-counting-down-my-hours-each-time-at-work/

12 Hours Shift – Counting Down My Hours Each Time At Work

A short article during my 6th and final rotation of my Housemanship period where we were required to complete a 12-hour shift every day.

The Theoretical Doctor